TET2基因阳性急性髓细胞白血病38例分析

The analysis of 38 acute myeloid leukemia patients with TET2 gene positive

目的:分析TET2基因阳性急性髓细胞白血病(AML)患者的临床及实验室特点,探讨可能影响治疗效果的因素。方法:收集38例TET2基因突变阳性AML患者的临床及实验室资料,并回顾性分析其中可能影响治疗效果的因素,TET2基因检测采用实时定量PCR方法。结果:38例患者中21例接受化疗,获得完全缓解(CR)12例(57.14%),未缓解(NR)5例(23.81%),疾病进展(PD)4例(19.05%)。应用不同化疗方案治疗后缓解率不同,应用去甲基化治疗的4例第一个疗程治疗后均达到完全缓解,未应用去甲基化治疗的17例中CR 8例(47.06%)、NR 5例(29.41%)、PD 4例(23.53%)。白血病细胞免疫表型CD34阴性、CD13阴性、CD33阳性者化疗后CR率更高,差异具有统计学意义(P<0.05)。TET2基因阳性AML患者的CR率与年龄、性别、发病时白细胞计数、血红蛋白、血小板计数、白血病细胞免疫表型(CD56、CD9、HLA-DR)、是否伴有其他预后基因及复杂染色体核型无明显相关性。结论:TET2基因阳性AML患者的CR率与化疗方案及白血病细胞免疫表型C D34、CD13及CD33相关。去甲基化治疗可提高TET2基因阳性AML患者的CR率。影响TET2基因阳性AML患者疗效及长期生存的因素尚需进一步探讨。

Objective： To investigate the clinical and laboratorial characteristics of TET2 gene positive acute myeloid leukemia（ AML） patients,to explore the factors of influence the treatment response. Methods： We included the clinical and laboratory data of 38 adult AML patients with TET2 gene mutant and analyzed retrospectively the factors that may influence the treatment response,the expression levels of TET2 mRNA were measured by Real- time PCR.Results： 21 cases of the 3 8 patients received induction chemotherapy,and the complete remission（ CR） rate was57. 14 %,non- remission（ NR） rate was 23. 81 %,and the progression of disease（ PD） rate was 19. 05 %. The remission rate was different after treatment with different chemotherapy regimens. Of the 21 cases,4 cases were treated with decitabine,the CR rate was 100 %,for the 17 cases not applied with decitabine,the CR rate was 47. 06 %,the NR rate was 29. 41 %,and the PD rate was 23. 53 %. CR rate in CD33 positive AML is higher than CD33 negative AML（ P〈0. 05）. CR rate in CD13 positive AML is lower than CD13 negative AML（ P〈0. 05）. CR rate in CD34 positive AML was lower than that in CD34 negative AML（ P〈0. 05）. Patients＇ age,gender,white blood cell count,hemoglobin and platelet count of the onset time,with or without other prognostic genes and karyotype changes were not significantly associated with CR rates. Conclusion： The CR rate of TET2 gene positive AML patients was significantly associated with induction chemotherapy and AML immune phenotype CD34,CD13,CD33. The effective rate of the group treated with decitabine was higher. The factors that influence the curative effect and long- term survival in AML patients with TET2 mutation to be further discussed.